Intestinal obstruction, progressive weight loss, and recurrent fever in two patients with mesenteric lesions.
We describe 2 patients who presented with fever and incomplete intestinal obstruction. Previously, both patients had had laparotomies showing unresectable lesions in the root of the mesentery which were histologically diagnosed as sclerosing mesenteritis in the first and mesenteric fibromatosis in the second patient. In spite of aggressive immunosuppressive therapy the first patient deteriorated with high-grade fever and progressive weight loss. Similar symptoms occurred in the second patient. Computed tomographic scanning revealed necrotic lesions in both patients which histologically were found to be an angiocentric T-cell lymphoma in the first and a superinfected necrotizing fibroma in the second patient. It is therefore clinically and radiologically impossible to distinguish between the different causes of mesenteric lesions. Reoperation for further biopsies needs to be considered if such patients do not respond to medical treatment.
Hoffmann
J C
JC
Department of Gastroenterology and Hepatology, Eberhard Karls University, Tübingen, Germany. 101504.3210@compuserve.com
Lamberts
R
R
Huppert
P
P
Kaiserling
E
E
Gregor
M
M
D000368:Aged; D005334:Fever / Q000209:etiology; D005350:Fibroma / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology*; D016399:Lymphoma, T-Cell / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008643:Mesentery; D008875:Middle Aged; D010534:Peritoneal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D011859:Radiography; D012008:Recurrence; D015431:Weight Loss